Emergency Departments (EDs) are an important area for patient safety research as they provide care to over 100,000,000 patients per year nationwide, and in many communities they are the primary portal for entry into a healthcare institution. Today's EDs could not function without a patient tracking system (electronic or manual "white boards") which contain clinical and logistical information about patients and provide caregivers with information about patient status (designated providers, treatment status, laboratory results, location). Tracking systems play a critical role in communicating many factors that have a direct effect on patient safety. As information technology becomes better integrated into the healthcare system, EDs will transition to electronic patient tracking systems. Simulation-based research is critical to ensure that as this technology is introduced any new opportunities for failure modes will have been identified a priori and addressed before they cause adverse events. The proposed research provides a unique utilization of simulation for patient safety oriented health care research and training. In contrast to numerous examples of patient simulators that have been developed for use in research and training (e.g., mannequin patients for anesthesia training), the proposed research utilizes an immersive laboratory environment to study caregiver interaction with patient tracking systems. The goals of this research are to demonstrate the use of simulation for usability testing, iterative design improvement, and training in the use of electronic patient tracking systems in order to help predict factors that have the potential to compromise patient safety. Patient tracking system displays and interfaces will be simulated on multiple computer screens and large screen displays, in a setting that allows caregiver participants to interact with the simulated patient tracking system, representative clinical tasks, and other people (caregiver participants or research confederates). Information displayed on the patient tracking system will be drawn from a real-time, interactive, discrete event simulation of an emergency department (ED) environment, and participant awareness, decisions, and actions will be measured in two experiments. This research implements simulation to study Emergency Department (ED) staff use of a computerized patient tracking system, in order to improve the design of these systems to support better patient care in hospital EDs. [unreadable] [unreadable] [unreadable]